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American Journal of Perinatology

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https://read.qxmd.com/read/31087317/does-a-care-bundle-reduce-racial-disparities-in-postcesarean-surgical-site-infections
#1
Tetsuya Kawakita, Jason G Umans
OBJECTIVE:  To examine the effect of a care bundle on racial disparities in surgical site infections (SSIs). STUDY DESIGN:  This was a retrospective cohort study of women undergoing cesarean delivery at ≥23 weeks' gestation. The care bundle included routine antibiotics (both cefazolin and azithromycin), chlorhexidine skin preparation, clippers, vaginal cleansing, placental removal by cord traction, subcutaneous tissue closure, suture skin closure, dressing removal in 24 to 48 hours, and postoperative chlorhexidine soap...
May 14, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31087316/effect-of-implementing-quantitative-blood-loss-assessment-at-the-time-of-delivery
#2
Elizabeth Coviello, Sara Iqbal, Tetsuya Kawakita, Rebecca Chornock, Megan Cheney, Sameer Desale, Melissa Fries
OBJECTIVE:  To evaluate the ability of estimated blood loss (EBL) and quantitative blood loss (qBL) to predict need for blood transfusion in women with postpartum hemorrhage (PPH). STUDY DESIGN:  This is a retrospective chart review that identified women with PPH (>1,000 mL for vaginal or cesarean delivery) between September 2014 and August 2015, reported by EBL ( n  = 92), and October 2015 and September 2016, reported by qBL ( n  = 374). The primary metric was the area under the receiver-operating characteristic curve for blood transfusion...
May 14, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31087315/study-of-gilbert-s-syndrome-associated-ugt1a1-polymorphism-in-jaundiced-neonates-of-abo-incompatibility-hemolysis-disease
#3
Yingfang Yu, Lizhong Du, An Chen, Lihua Chen
OBJECTIVE:  To assess the probable relationship between icter in neonates with ABO incompatibility hemolysis and UGT1A1 gene polymorphism. STUDY DESIGN:  There were 65 ABO hemolytic disease of the newborn (HDN) neonates of full term in the study group and 82 non-ABO HDN neonates of full term in the compared group. We tested the UGT1A1 gene mutation of neonates of ABO HDN and non-ABO HDN. We compared the incidence of hyperbilirubinemia between neonates with and without UGT1A1 mutations in the ABO HDN and non-ABO HDN, to determine the relationship between icter in neonates with ABO HDN and UGT1A1 gene polymorphism...
May 14, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31087314/risk-factors-for-30-day-mortality-in-neonatal-gram-negative-bacilli-sepsis
#4
Anucha Thatrimontrichai, Nutchana Premprat, Waricha Janjindamai, Supaporn Dissaneevate, Gunlawadee Maneenil
OBJECTIVE:  Multidrug-resistant gram-negative bacilli (MDR-GNB) have emerged globally as a serious threat and with a high case fatality rate (CFR). STUDY DESIGN:  We performed a case-control study in a Thai neonatal intensive care unit to identify the risk factors for 30-day CFR of GNB sepsis between 1991 and 2017. The CFR was analyzed by Cox's proportional hazards model. RESULTS:  For 27 years, the percentage of MDR-GNB from GNB sepsis was 66% (169/257)...
May 14, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31087313/role-of-oropharyngeal-administration-of-colostrum-in-very-low-birth-weight-infants-for-reducing-necrotizing-enterocolitis-a-randomized-controlled-trial
#5
Deepak Sharma, Amandeep Kaur, Nazanin Farahbakhsh, Sunil Agarwal
AIM:  To study the role of oropharyngeal administration of colostrum (OAC) in very-low-birth-weight infants for reducing necrotizing enterocolitis (NEC). STUDY DESIGN:  In this randomized controlled trial, 117 infants were enrolled, 59 were randomized to OAC group and 58 to routine care group. Infants with birth weight ≤ 1,250 g and/or gestational age ≤ 30 weeks were enrolled. Infants in OAC group received maternal colostrum (0.2 mL), 0.1 mL on either side, after 24 hours of postnatal life and were given every 2 hour for the next 72 hours irrespective of the enteral feeding status of the neonate...
May 14, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31087312/useful-platelet-indices-for-the-diagnosis-and-follow-up-of-patent-ductus-arteriosus
#6
Elif Guler Kazanci, Mehmet Buyuktiryaki, Handan Unsal, Cuneyt Tayman
OBJECTIVE:  The aim of this study was to assess the utility of early postnatal platelet indices in the prediction of hemodynamically significant patent ductus arteriosus (hsPDA) and its response to pharmacological treatment in preterm infants. STUDY DESIGN:  The medical records of 971 infants with gestational age < 30 weeks and birth weight < 1,500 g were analyzed retrospectively. Infants with hsPDA comprised the study group and those without hsPDA comprised the control group...
May 14, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31087311/findings-in-stillbirths-associated-with-placental-disease
#7
Karen J Gibbins, Halit Pinar, Uma M Reddy, George R Saade, Robert L Goldenberg, Donald J Dudley, Carolyn Drews-Botsch, Alexa Ann Freedman, Lauren M Daniels, Corette B Parker, Vanessa Thorsten, Radek Bukowski, Robert M Silver
OBJECTIVE:  Placental disease is a leading cause of stillbirth. Our purpose was to characterize stillbirths associated with placental disease. STUDY DESIGN:  The Stillbirth Collaborative Research Network conducted a prospective, case-control study of stillbirths and live births from 2006 to 2008. This analysis includes 512 stillbirths with cause of death assignment and a comparison group of live births. We compared exposures between women with stillbirth due to placental disease and those due to other causes as well as between women with term (≥ 37 weeks) stillbirth due to placental disease and term live births...
May 14, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31071726/timing-of-delivery-in-pregnancies-complicated-by-suspected-fetal-growth-restriction-without-doppler-abnormalities
#8
Beth L Pineles, Sarah Crimmins, Ozhan Turan
OBJECTIVE:  To identify the optimal gestational age for delivery of pregnancies complicated by fetal growth restriction (FGR) without Doppler abnormalities. STUDY DESIGN:  Cases of FGR (ultrasound-estimated fetal weight less than the 10th or abdominal circumference less than the 5th percentile for gestational age) without fetal Doppler abnormalities were identified from a fetal ultrasound database. The primary outcome was a composite of perinatal mortality and morbidity...
May 9, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31039598/beyond-cervical-length-association-between-postcerclage-transvaginal-ultrasound-parameters-and-preterm-birth
#9
Ashley N Battarbee, Joshua S Ellis, Tracy A Manuck
OBJECTIVE:  To assess the value of transvaginal ultrasound parameters after cerclage placement in estimating the risk of spontaneous preterm birth. STUDY DESIGN:  This is a retrospective cohort at a single tertiary care center from 2013 to 2016. Women carrying a singleton, nonanomalous fetus with cerclage in situ and at least one postcerclage transvaginal ultrasound from 160/7 to 256/7 weeks' gestation were included. In addition to abstracting maternal demographic and obstetric characteristics, two study investigators separately reviewed each of the images from the first transvaginal ultrasound after cerclage placement, masked to pregnancy outcomes...
April 30, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31039597/outcomes-of-elective-induction-of-labor-versus-expectant-management-among-obese-women-at-%C3%A2-39-weeks
#10
Anna Palatnik, Michelle A Kominiarek
BACKGROUND:  Maternal obesity is associated with many adverse obstetric outcomes including cesarean delivery. It is unclear whether induction of labor can reduce these risks. Previous studies report conflicting results on the outcomes of elective induction of labor among obese women. OBJECTIVE:  To compare maternal and neonatal outcomes between obese women undergoing elective induction of labor and those undergoing expectant management at ≥39 weeks. STUDY DESIGN:  This was a retrospective cohort study from the Consortium on Safe Labor of obese women (defined by prepregnancy body mass index≥ 30kg/m2 ) with singleton gestations at ≥39 weeks without medical comorbidities from 2002 through 2008...
April 30, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31039596/disparities-in-health-care-associated-infections-in-the-nicu
#11
Jessica Liu, Charlotte Sakarovitch, Krista Sigurdson, Henry C Lee, Jochen Profit
OBJECTIVES:  This study aimed to examine multilevel risk factors for health care-associated infection (HAI) among very low birth weight (VLBW) infants with a focus on race/ethnicity and its association with variation in infection across hospitals. STUDY DESIGN:  This is a population-based cohort study of 20,692 VLBW infants born between 2011 and 2015 in the California Perinatal Quality Care Collaborative. RESULTS:  Risk-adjusted infection rates varied widely across neonatal intensive care units (NICUs), ranging from 0 to 24...
April 30, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31013540/understanding-the-heterogeneity-of-labor-and-delivery-units-using-design-thinking-methodology-to-assess-environmental-factors-that-contribute-to-safety-in-childbirth
#12
Jules P Sherman, Laura C Hedli, Alexandria I Kristensen-Cabrera, Steven S Lipman, Doug Schwandt, Henry C Lee, Lillian Sie, Louis P Halamek, Naola S Austin
OBJECTIVE:  There is limited research exploring the relationship between design and patient safety outcomes, especially in maternal and neonatal care. We employed design thinking methodology to understand how the design of labor and delivery units impacts safety and identified spaces and systems where improvements are needed. STUDY DESIGN:  Site visits were conducted at 10 labor and delivery units in California. A multidisciplinary team collected data through observations, measurements, and clinician interviews...
April 23, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31013539/early-premature-infant-oral-motor-intervention-improved-oral-feeding-and-prognosis-by-promoting-neurodevelopment
#13
Xiao-Li Li, Yun Liu, Miao Liu, Chun-Yan Yang, Qiao-Zhi Yang
OBJECTIVE:  To explore the clinical significance of early premature infant oral motor intervention (PIOMI) in the prognosis of premature infants. STUDY DESIGN:  Infants were randomly divided into an intervention group ( n  = 78) and a control group ( n  = 73). PIOMI was given to the intervention group 15 to 30 minutes before feeding once a day for 14 days. The whole procedure lasted 15 minutes, including oral stimulation and nonnutritive sucking. Oral feeding ability and neuromotor development were evaluated using the Preterm Infant Oral Feeding Readiness Assessment (PIOFRA) scale and Infant Neurological International Battery (Infanib) scale...
April 23, 2019: American Journal of Perinatology
https://read.qxmd.com/read/31003242/oxygen-saturation-and-perfusion-index-based-enhanced-critical-congenital-heart-disease-screening
#14
Heather Siefkes, Laura Kair, Daniel J Tancredi, Brian Vasquez, Lorena Garcia, Christa Bedford-Mu, Satyan Lakshminrusimha
OBJECTIVE:  To determine if addition of perfusion index (PIx) to oxygen saturation (SpO2 ) screening improves detection of critical congenital heart disease (CCHD) with systemic outflow obstruction. STUDY DESIGN:  We determined screening thresholds for PIx and applied these to a cohort of newborns with and without congenital heart disease (CHD). RESULTS:  A total of 123 normal and 21 CHD newborns (including five with critical systemic outflow obstruction) were enrolled...
April 19, 2019: American Journal of Perinatology
https://read.qxmd.com/read/30999382/the-lowering-of-bilirubin-levels-in-full-term-newborns-by-the-effect-of-combined-massage-therapy-and-phototherapy-practice
#15
Shokoufeh Ahmadipour, Mahnaz Mardani, Azam Mohsenzadeh, Parastoo Baharvand, Mohammad Ghaed Nazeri
OBJECTIVE:  Various therapeutic treatments have been prescribed for decreasing the bilirubin level. Massage therapy is one of the neonate treatments for jaundice. The aim of this study is to investigate the effects of combined massage therapy and phototherapy on neonatal jaundice. STUDY DESIGN:  This study was performed at Shahid Madani Hospital in the city of Khorramabad in 2016, where 83 healthy full-term infants were enrolled. They were selected through convenience sampling and then were randomly assigned to the intervention and control groups...
April 18, 2019: American Journal of Perinatology
https://read.qxmd.com/read/30991442/the-accuracy-and-cost-effectiveness-of-selective-fetal-echocardiography-for-the-diagnosis-of-congenital-heart-disease-in-patients-with-pregestational-diabetes-stratified-by-hemoglobin-a1c
#16
Matthew M Finneran, Courtney A Ware, Miranda K Kiefer, Elizabeth O Buschur, Pamela M Foy, Stephen F Thung, Mark B Landon, Steven G Gabbe
OBJECTIVE:  To evaluate the accuracy of antenatal diagnosis of congenital heart disease (CHD) using screening methods including a combination of elevated hemoglobin A1c, detailed anatomy ultrasound, and fetal echocardiography. STUDY DESIGN:  This is a retrospective cohort study of all pregnancies complicated by pregestational diabetes from January 2012 to December 2016. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each screening regimen...
April 16, 2019: American Journal of Perinatology
https://read.qxmd.com/read/30991441/sex-specific-differences-in-late-preterm-neonatal-outcomes
#17
Ashley N Battarbee, Angelica V Glover, Catherine J Vladutiu, Cynthia Gyamfi-Bannerman, Sofia Aliaga, Tracy A Manuck, Kim A Boggess
OBJECTIVE:  To estimate sex-specific differences in late preterm outcomes and evaluate whether betamethasone modifies this association. STUDY DESIGN:  We conducted a secondary analysis of a multicenter trial of women at risk for late preterm birth randomized to receive betamethasone or placebo. We included women who delivered at 34 to 37 weeks and excluded major fetal anomalies. The primary outcome was severe neonatal morbidity (mechanical ventilation, respiratory distress syndrome, bronchopulmonary dysplasia, sepsis, necrotizing enterocolitis, and intraventricular hemorrhage)...
April 16, 2019: American Journal of Perinatology
https://read.qxmd.com/read/30991440/effect-of-trial-of-labor-before-cesarean-and-risk-of-subsequent-placenta-accreta-spectrum-disorders
#18
Katharine N O'Malley, Mary E Norton, Sarah S Osmundson
OBJECTIVE:  To examine whether labor before cesarean affects the risk of placenta accreta spectrum (PAS) disorders in a subsequent pregnancy. STUDY DESIGN:  This is a secondary analysis of the Cesarean Registry, a prospective cohort study of women undergoing cesarean between 1999 and 2002. Women with one prior cesarean with known indications, which were categorized as likely associated with labor (labored cesarean) versus likely not associated with labor (unlabored cesarean), were included...
April 16, 2019: American Journal of Perinatology
https://read.qxmd.com/read/30991439/effects-of-mtnr1b-genetic-variants-on-individual-susceptibility-to-gestational-diabetes-mellitus-a-meta-analysis
#19
Guangliang Jia, Yanxiang Gao, Chunzhi Li, Yanqin Zhang
OBJECTIVE:  Whether melatonin receptor 1B ( MTNR1B ) variants are implicated in gestational diabetes mellitus (GDM) remains unclear. Therefore, we performed this meta-analysis to obtain a more conclusive result on associations between MTNR1B variants and GDM. STUDY DESIGN:  Literature research was performed in PubMed, Web of Science, Embase, and China National Knowledge Infrastructure. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS:  A total of 17 studies were eligible for analyses...
April 16, 2019: American Journal of Perinatology
https://read.qxmd.com/read/30991438/sentinel1-two-season-study-of-respiratory-syncytial-virus-hospitalizations-among-u-s-infants-born-at-29-to-35-weeks-gestational-age-not-receiving-immunoprophylaxis
#20
Evan J Anderson, John P DeVincenzo, Eric A F Simões, Leonard R Krilov, Michael L Forbes, Pia S Pannaraj, Claudia M Espinosa, Robert C Welliver, Leslie I Wolkoff, Ram Yogev, Paul A Checchia, Joseph B Domachowske, Natasha Halasa, Scott J McBride, Veena R Kumar, Kimmie K McLaurin, Christopher P Rizzo, Christopher S Ambrose
OBJECTIVE:  The SENTINEL1 observational study characterized confirmed respiratory syncytial virus hospitalizations (RSVH) among U.S. preterm infants born at 29 to 35 weeks' gestational age (wGA) not receiving respiratory syncytial virus (RSV) immunoprophylaxis (IP) during the 2014 to 2015 and 2015 to 2016 RSV seasons. STUDY DESIGN:  All laboratory-confirmed RSVH at participating sites during the 2014 to 2015 and 2015 to 2016 RSV seasons (October 1-April 30) lasting ≥24 hours among preterm infants 29 to 35 wGA and aged <12 months who did not receive RSV IP within 35 days before onset of symptoms were identified and characterized...
April 16, 2019: American Journal of Perinatology
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